以健康信念模式預測接受經皮冠狀動脈介入治療病人的運動行為

Exploring Exercise Behavior after Percutaneous Coronary Intervention

背景：規律運動可以改善多數冠心病的危險因子，然而國內研究發現接受經皮冠狀動脈介入治療後病人未從事規律運動達47~74%。
目的：應用健康信念模式探討接受經皮冠狀動脈介入治療，病人出院後三個月的運動行為及其預測因素。
方法：採前瞻縱貫性研究設計，以方便取樣，在新北市某醫院心臟科病房接受經皮冠狀動脈介入治療的病人為研究對象，共收案138人，完成三個月的追蹤有125位。住院期間收集病人的人口學變項、過去運動習慣、健康信念（自覺罹病性、自覺嚴重性、自覺利益、自覺障礙和運動自我效能），出院後第二週收集行動線索，及出院後每週收集運動行為。
結果：31.2%的病人在接受經皮冠狀動脈介入治療出院後，會從事12週規律運動行為。以羅吉斯迴歸檢驗基於健康信念模式的四種研究模式，結果皆呈現運動自我效能、內在行動線索、疾病診斷與過去的運動習慣為規律運動行為之預測因子。
結論／實務應用：研究結果可作為護理人員指導接受經皮冠狀動脈治療後病人從事規律運動之參考。

Background: Regular exercise significantly mitigates risk factors for coronary heart disease; however, longitudinal data indicates that 47% to 74% of patients fail to maintain consistent physical activity following percutaneous coronary intervention (PCI).
Purpose: This study applied the Health Belief Model (HBM) to investigate exercise behaviors and identify key predictors of adherence three months post-discharge in PCI patients.
Methods: Using a prospective longitudinal design, a convenience sample of 138 participants was recruited from a cardiology ward in New Taipei City, with 125 completing the three-month follow-up. Data regarding demographics, previous exercise habits, and HBM constructs (perceived susceptibility, severity, benefits, barriers, and self-efficacy) were collected during hospitalization. Cues to action were assessed two weeks post-discharge, while exercise behaviors were monitored weekly for three months.
Results: Only 31.2% of patients engaged in regular exercise during the 12-week follow-up period. Logistic regression analysis of four models based on the HBM identified exercise self-efficacy, internal cues to action, medical diagnosis, and pre-existing exercise habits as significant predictors of regular exercise behavior.
Conclusion/Implications for Practice: These findings provide a targeted framework for nursing interventions, suggesting that education should prioritize boosting patient self-efficacy and leveraging internal motivators to improve long-term exercise adherence and cardiovascular health.